Osteoporosis is a systemic skeletal disease in which mineral density falls and the microarchitecture of the bone is disrupted: it becomes fragile and breaks even with minor trauma. The diagnosis is made by densitometry — a T-score ≤ −2.5 standard deviations.
The disease runs without symptoms for a long time, and the first sign is often a fracture of a vertebra, the femoral neck or the wrist. The main "building materials" of bone are calcium and vitamin D.
Why it develops
Bone is renewed throughout life: old tissue is resorbed and new tissue is built. With age the balance shifts toward breakdown. Loss is accelerated by an estrogen deficit after menopause, a shortage of calcium and vitamin D, physical inactivity, smoking, alcohol abuse and taking glucocorticoids.
Secondary osteoporosis is distinguished separately — against the background of other diseases: hyperparathyroidism, hyperthyroidism, celiac disease, chronic kidney disease, long-term hormone therapy.
Why it is dangerous and its link to aging
The main danger is fractures from minimal trauma. A hip fracture in old age often leads to loss of independence and raises mortality within a year. Compression fractures of the vertebrae reduce height and deform posture.
Osteoporosis often goes hand in hand with sarcopenia — the loss of muscle mass; their combination ("osteosarcopenia") especially raises the risk of falls and fractures and is considered a marker of aging of the musculoskeletal system.
Diagnosis and prevention
The main method is DXA densitometry of the spine and hip; fracture risk is additionally assessed with the FRAX calculator. In lab tests, calcium, vitamin D, alkaline phosphatase and parathyroid hormone are checked to rule out secondary causes.
Prevention: enough calcium (about 1000–1200 mg per day) and vitamin D, regular strength and weight-bearing exercise, balance training, quitting smoking. At high risk the doctor prescribes medication — bisphosphonates or denosumab.
Reference ranges
Diagnosis by densitometry (DXA) of the central skeleton — by T-score (in postmenopausal women and men ≥ 50 years), WHO classification:
| Normal | T-score ≥ −1.0 |
| Osteopenia (low bone mass) | T-score from −1.0 to −2.5 |
| Osteoporosis | T-score ≤ −2.5 |
| Severe osteoporosis | T ≤ −2.5 + a low-trauma fracture |
Calculate using this marker
Calculators where Osteoporosis is used directly:
Frequently asked questions
Are osteoporosis and osteopenia the same thing?
No. Osteopenia is a moderate reduction in bone density (T-score from −1.0 to −2.5), an intermediate stage and a "warning". Osteoporosis is a more pronounced loss (T ≤ −2.5) with a high fracture risk.
Can bone be restored in osteoporosis?
Bone cannot be fully "regrown", but treatment (calcium, vitamin D, strength exercise and, when indicated, bisphosphonates or denosumab) can slow the loss, increase density and markedly reduce fracture risk.